| Marise Kelly, M.d., P.a. | |
|
900 Broadway St Houston TX 77012-2127 | |
| (713) 928-2774 | |
| (713) 928-2781 |
| Full Name | Marise Kelly, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 900 Broadway St, Houston, Texas |
| Authorized Official Name and Position | Marise Kelly (DIRECTOR) |
| Authorized Official Contact | 7139282774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marise Kelly, M.d., P.a. 900 Broadway St Houston TX 77012-2127 Ph: (713) 928-2774 | Marise Kelly, M.d., P.a. 900 Broadway St Houston TX 77012-2127 Ph: (713) 928-2774 |
| NPI Number | 1790010064 |
|---|---|
| Provider Enumeration Date | 10/05/2009 |
| Last Update Date | 05/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790010064 | NPI | - | NPPES |
| 219659401 | Medicaid | TX | |
| 219659402 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J9727 (Texas) | Primary |
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